Mumbai: Expectant mother? Mask up, especially in last trimester!

Newborns of women who contracted the Omicron variant of COVID19 in the last three months of pregnancy face the threat of MISN multisystem inflammatory syndrome in neonates In the past nine months 15 newborns succumbed to MISN in Vadodara Gujarat claim gynaecologists and paediatricians who are treating a newborn who is on highflow ventilator support as his lungs have been damagedDoctors have advised all expectant parents to wear N95 masks as the only path through which the virus can reach the foetus is the mother Even if the pregnancy is at fullterm stage the foetus can develop lung complications doctors said Immunologist Dr Jacob John of Vellore said such cases should be brought to the attention of the Indian Council of Medical Research and National Institute of Virology whose experts must ascertain the reason behind the lung infectionsDr Rajesh Parikh an obstetrician and gynaecologist who runs the Madhuvan Maternity and Eye Hospital in Vadodara said ldquoFour newborns from my maternity home were diagnosed with COVIDrelated MISN and three have succumbed The fourth a threekg baby who was delivered fullterm with no problems at the time of birth suddenly showed persistent grunting and had to be shifted to the neonatal ICUrdquo A tweet by Dr Parikh on the newbornrsquos condition in late September has gone viral on social media and is also being discussed by medical expertsThe tweet by Dr Rajesh Parikh which went viralldquoThe infant has been shifted to a bigger setup Kashiben Gordhandas Patel Children Hospital where he is in the able hands of wellknown paediatrician Dr Jainish Bhandarirdquo said Dr Parikh According to the doctor the babyrsquos parents had taken both doses of the vaccine and had no history of COVID19 ldquoThe parents are in shock as the child was born healthy and is suddenly fighting for his life The prognosis is grim MISN is a war we seem to be losing despite our best efforts MISC Multisystem Inflammatory Syndrome in Children is not as terrible in outcome as MISNrdquoAlso Read Despite big gatherings Mumbai saw drop in Covid19 casesHe added that most MISN cases had some symptoms in common ldquoThere are no signs of infection All blood work for the septic screen turned out negative All had a very high antibody titer There were no active symptoms in the mother Uneventful peripartum phase and delivery occurredrdquo he said Appealing to all pregnant women to take care the doctor said ldquoOmicron is dangerous for neonates Couples should wear masks the same way they refrain from drinking alcohol from the time they learn about the pregnancyrdquoInfant still putting up a fightDr Bhandari said ldquoUsually we see MISN cases where the newbornrsquos condition suddenly deteriorates and they succumb to the disease within 24 to 36 hours of admission in the neonatal ICU In this case the infant is fighting every moment and we all are hoping for a positive outcomerdquo ldquoWhile infants with MISN are mainly presenting with respiratory distress mostly at birth older children are presenting with cardiac complicationsrdquo he added He stated that a lot of aspects of longterm COVID remain a mystery ldquoThe only way to protect oneself right now is by wearing a mask and social distancingrdquo he addedWhat is MISNDr Bhandari said when a mother contracts the virus her body produces antibodies which reach the baby via the placenta ldquoAs the antibodies donrsquot find any COVID antigen to destroy they end up harming the foetusrsquos lung tissue So newborns who are genetically susceptible to developing multisystemic inflammatory disorders donrsquot have lungs that can maintain oxygenation of the body once the placenta is cut after delivery And hence pregnant women must take utmost care and mask up The mother might not get anything more than mild symptoms but the child can end up with serious complications This is a relatively new disease we understand little about Donrsquot take it lightlyrdquo he saidExpert viewDr Jacob said ldquoWe must collect as much information as possible before we come to any conclusionrdquo He added ldquoThe Omicron variant doesnrsquot affect the lungs directly We must also understand the antibody normal globulin a protein which by itself cannot damage tissue and we therefore cannot jump to conclusionsrdquo15Estimated no of newborns who succumbed to MISN in Baroda in nine months